Optical coherence tomography shows promise for assessing nail
10 August 2011
Recent studies by the Musculoskeletal Biomedical Research Unit
at Leeds University NHS Trust, UK, indicate that optical coherence
tomography has considerable potential for the evaluation of psoriatic
Nail disease, which occurs in 10-55% of patients with psoriasis and
in 53-86% of patients with psoriatic arthritis, is increasingly
recognised to be of major clinical and research relevance. As yet,
there are no objective methods to diagnose and assess nail disease
in these patients.
An initial case study, published in Dermatology, compared
nail bed images produced by the Michelson Diagnostics VivoSight OCT
scanner with those produced using High Resolution Ultrasound1.
The OCT images which showed much higher-resolution changes than
Ultrasound, correlated with the clinical observation of subungual
hyperkeratosis (Fig 1 & 2 below) These preliminary findings, which
were also presented at a recent GRAPPA meeting (Group for Research
and Assessment of Psoriasis and Psoriatic Arthritis) show that OCT
has great potential for the systematic characterisation of nail
changes in psoriasis and this could have implications for diagnosis,
prognosis and monitoring of therapies and for a better understanding
of nail disease pathogenesis.
Fig 1: VivoSight OCT (1A) and ultrasound (1B)
images of a healthy nail
Picture (2A), corresponding VivoSight OCT (2B)
and US (2C) images of a psoriatic nail.
The Leeds Psoriatic Arthritis Research Group, led by Prof Dennis
McGonagle, is conducting further studies which will be published in
the coming months.
Professor McGonagle stated, “VivoSight offers unparalleled nail
imaging capabilities that appear to have the same potential as
microscopy for elucidating the microanatomical basis for nail
disease. This could be key for predicting arthritis development in
psoriasis cases and helping with timely treatment strategies”
The VivoSight scanner uses OCT which provides images of sub-surface
tissue similar to ultrasound, but at far higher resolution, enabling
the clinician to see critical details in real time and without
exposing the patient to ionising radiation. Michelson Diagnostics
has already obtained CE mark and FDA clearance for clinical use of
the scanner in Europe and USA, and it is being evaluated at leading
research centres in Europe and USA.
1 Zehra, S. et al. Optical Coherence Tomography: A New
Tool to Assess Nail Disease in Psoriasis?. Dermatology,
DOI: 10.1159/000329434. S. Karger AG, Basel.
Source: Michelson Diagnostics